Survival in systemic sclerosis-pulmonary arterial hypertension by serum autoantibody status in the Pulmonary Hypertension Assessment and Recognition of Outcomes in Scleroderma (PHAROS) Registry

  • Monique Hinchcliff
  • , Saira Khanna
  • , Vivien M. Hsu
  • , Jungwha Lee
  • , Orit Almagor
  • , Rowland W. Chang
  • , Virginia Steen
  • , Lorinda Chung
  • , Marcy B. Bolster
  • , Mary E. Csuka
  • , Chris T. Derk
  • , Robyn T. Domsic
  • , Aryeh Fischer
  • , Tracy Frech
  • , Daniel Furst
  • , Avram Z. Goldberg
  • , Mardi Gomberg-Maitland
  • , Jessica K. Gordon
  • , Laura K. Hummers
  • , Firas Kassab
  • Jerry A. Molitor, Ioana Preston, Lesley Ann Saketkoo, Elena Schiopu, Rick Silver, Robert Simms, John Varga

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Objective: To determine the association between serum autoantibodies and survival in patients with incident systemic sclerosis (SSc)-pulmonary arterial hypertension (PAH) enrolled in the Pulmonary Hypertension Assessment and Recognition of Outcomes in Scleroderma (PHAROS) Registry. Methods: Patients with definite PAH diagnosed by right heart catheterization within 6 months of registry enrollment were studied. Serum autoantibodies were assayed at each participating institution's clinical laboratory. Mortality data were collected from electronic medical records and/or the Social Security Death Index. Kaplan-Meier survival estimates were reported for five autoantibody groups (anticentromere/AC, nucleolar ANA/NUC, anti-topoisomerase/Scl-70, overlapping or non-specific autoantibodies/other, and a combined group with similar survival consisting of RNA polymerase III, U1RNP, and autoantibody-negative patients). Cox proportional hazards models permitted examination of the association between autoantibody groups and overall survival, controlling for age, sex, race, and SSc disease duration. Results: In all, 162 subjects had PAH, and serum autoantibody and survival information; 60 (37%) had AC, 39 (24%) NUC, 11 (7%) Scl-70, 28 (17%) had other, 9 (6%) RNA pol, 8 (5%) U1RNP autoantibodies, and 7 (4%) had negative antibodies; 32 (20%) subjects died over a median follow-up time of 2.1 years (range: 0.01-6.8); 1- and 3-year survival estimates were, respectively, 94% and 78% for AC, 94% and 72% for NUC, 89% and 63% for Scl-70, 92% and 79% for the other group, and 100% and 93% for the combined group. Unadjusted and adjusted hazard ratios revealed no statistically significant association between risk of death and autoantibodies. Conclusion: Anticentromere and NUC autoantibodies are prevalent in SSc-PAH patients. An association between serum autoantibodies and survival in patients with SSc-PAH was not identified in the PHAROS cohort.

Original languageEnglish (US)
Pages (from-to)309-314
Number of pages6
JournalSeminars in Arthritis and Rheumatism
Volume45
Issue number3
DOIs
StatePublished - Dec 2015

Bibliographical note

Publisher Copyright:
© 2015 Elsevier Inc.

Keywords

  • Mortality
  • Pulmonary arterial hypertension
  • Pulmonary hypertension
  • Risk factors
  • Scleroderma
  • Serum autoantibody
  • Systemic sclerosis

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